Removing “sweet burden” by gastrectomy and interventional surgery

Yang Tiantian, the gold manager and CEO of one heart Entertainment, who built Zhang Yuqi into a “cool lady”, recently announced that he had undergone gastrectomy, hoping to reduce blood sugar quickly. In fact, if you want to lower blood sugar, there is not only gastrectomy, but also minimally invasive intervention can help “old sugar friends” to unload the “sweet burden”.

Zheng Chao, deputy director of the Department of Endocrinology, the Second Affiliated Hospital of Zhejiang University Medical College, said, “gastrectomy is a mature technology, which is now accepted by more and more people.”.

Zheng Chao introduced that at present, Roux-en-Y gastric bypass surgery and sleeve gastrectomy are the main operation methods of weight loss surgery. Both operations can significantly reduce the weight of obese patients and alleviate obesity related complications. It was first used to treat morbidly obese patients, but later doctors found that it also helped control blood sugar. In 2009, the American Diabetes Association guidelines for the treatment of type 2 diabetes mellitus officially listed weight loss surgery as one of the measures to treat obese type 2 diabetes. Later, China’s guidelines for the prevention and treatment of type 2 diabetes also included the relevant content of weight loss surgery. However, weight-loss surgery is not to be done as soon as you want to do it. It is not only necessary to evaluate comprehensively before operation, but also to manage systematically after operation.

who is suitable for gastrectomy? Zheng Chao said that this not only depends on the weight, but also needs to consider the patient’s abdominal obesity and the concomitant diseases caused by excess fat. For patients with diabetes, it is necessary to combine the course of type 2 diabetes and the reserve capacity of islet function.

Ms. Li, 68, has been suffering from diabetes for 30 years. Her blood sugar once soared to 30 mmol / L, and her glycosylated hemoglobin rose to 12%. Insulin and a variety of hypoglycemic drugs have been used, but blood sugar is still high. Professor Teng gaojun, President of Zhongda Hospital Affiliated to Southeast University, used the latest “weapons” to perform endovascular denervation and radiofrequency ablation of “paralyzed” nerves. Half a year after the operation, Ms. Li’s blood glucose has been maintained at 6.5 mmol / L, glycosylated hemoglobin 5.9%, only a small amount of insulin is needed.

Teng gaojun introduced that the operation, which made Ms. Li’s blood sugar drop for a long time, was carried out under local anesthesia. During the operation, only a slender guide wire entered from the femoral artery. After precise positioning, the abdominal aorta was found, and then the spiral ring with six electrodes was delivered to the celiac artery. Through radiofrequency ablation, the blood vessels and nerves were damaged or partially damaged under the high temperature within 60 ℃. The increase of sympathetic excitability is the main cause of a series of metabolic function changes, such as impaired fasting blood glucose, insulin resistance, hypertension, obesity and so on. Therefore, to find ways to let the sympathetic nerve into a “dormant” state, insulin resistance decreased, blood sugar also dropped.

intravascular sympathetic denervation for diabetes mellitus is currently in clinical application stage, especially suitable for patients with diabetes mellitus history less than 10 years, aged from 18 to 75 years, suffering from refractory type 2 diabetes, complicated with metabolic syndrome and poor control of various drugs. The operation also has a certain effect on diabetic complications. Pets